Category Archives: Sex And Aging

Time to make room for sex in our care homes

We need to open up to the significance of love and sexuality in later life

The persistence of romantic love in long-term relationships is, unsurprisingly, associated with higher levels of relationship satisfaction.

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Although Valentine’s Day is often criticised as a cynical creation by florists and the greeting cards industry, it is a useful focal point for considering love and sexuality as elements of human wellbeing that often escape attention in healthcare.

This neglect is most marked in later life, when popular discourse on late life romance is dominated by simple notions of asexuality or by ribald jokes

There are many reasons why healthcare professionals need to learn more about human love and sexuality, not least of which is a fuller understanding of the nature and meaning of ageing.

exuality is a core element of human nature, encompassing a wide range of aspects over and above those related to genital functions, and the medical literature has rightly been criticised for taking too narrow a vision of sexuality.

We need to open up to the continuing significance of love and sexuality into later life

This narrow vision is paralleled by a steady trend in the neurosciences of “neuroreductionism”, an over-simplistic analysis of which parts of the brain light up in sophisticated scanners on viewing photos of a loved one.

We need to open up to the continuing significance of love and sexuality into later life, understanding that sexuality includes a broad range of attributes, including intimacy, appearance, desirability, physical contact and new possibilities.

Studies

Numerous studies affirm sexual engagement into the extremes of life, with emerging research on the continuing importance of romantic love into late life. There is also reassuring data on the persistence of romantic love in long-term relationships, unsurprisingly associated with higher levels of relationship satisfaction.

A growing literature sheds light on developing new relationships in later life, with a fascinating Australian study on online dating which subverts two clichés – that older people are asexual and computer illiterate.

The challenge in ageing is best reflected in the extent to which we enable and support intimacy and sexuality in nursing homes. Although for many this is their new home, the interaction of institutional life (medication rounds, meals), issues of staff training and lack of attention to design of spaces that foster intimacy can check the ability to foster relationships and express sexuality.

For example, is the resident’s room large enough for a sofa or domestic furnishings that reflects one’s style, personality and sense of the romantic? Are sitting spaces small and domestic rather than large day rooms? Do care routines allow for privacy and intimacy? Is there access to a selection of personal clothes, make-up and hairdressing?

Granted, there can also be complicated issues when residents with dementia enter new relationships and the need to ensure consent in a sensitive manner, but these should be manageable with due training and expertise in gerontological nursing and appropriate specialist advice.

Supports

A medical humanities approach can provide useful supports in education from many sources, ranging from literature ( Love in the Time of Cholera), film ( 45 Years or the remarkable and explicit Cloud 9 from 2009) or opera (Janácek’s Cunning Little Vixen, a musical reflection of the septuagenarian composer’s passion for the younger Kamila Stösslová).

We, as present and future older Irish people, also need to take a step back and consider if we are comfortable with a longer view on romance and sexuality.

The Abbey Theatre did us considerable service in 2015 with a wonderful version of A Midsummer Night’s Dream set in a nursing home. We were struck by a vivid sense of the inner vitality of these older people, suffused with desire, passion and romance.

This contemporary understanding of companionship and sexuality in later life was enhanced by casting Egeus as a son exercised about his mother’s romantic choices instead of a father at odds with his daughter.

We can also take heart from an early pioneer of ageing and sexuality, the late Alex Comfort. Best known for his ground-breaking The Joy of Sex, he was also a gerontologist of distinction, and wrote knowledgeably about the intersection of both subjects with characteristic humour.

He wrote that the things that stop you having sex with age are exactly the same as those that stop you riding a bicycle: bad health, thinking it looks silly or having no bicycle, with the difference being that they happen later for sex than for the bicycle.

His openness and encouragement for our future mirror Thomas Kinsella’s gritty poem on love in later life, Legendary Figures in Old Age, which ends with the line: ‘We cannot renew the Gift but we can drain it to the last drop.’

Complete Article HERE!

Lust, sex and the middle-aged woman

Women’s sexuality doesn’t die with age, but the level of their desire is diverse.

By Margaret Jennings

She seemed to have it all: a loving family, successful career and beautiful home.

Then Yvonne Carmichael jeopardised everything by having a torrid affair with a random stranger, ripping apart the cosy trajectory of her life.

Yvonne is the lead character in a BBC1 mini-series currently steaming up our TV screens, called Apple Tree Yard.

And while the storyline takes us from the joys of lust to the darkness of rape, it’s rare to see a 50-something female take centre stage in such scenes.

Midlife affairs are usually the reserve of testosterone-driven, crisis-ridden males — as if females have no such needs — or so the media world would have us believe.

Apple Tree Yard, a dramatised version of a novel by Amanda Coe, challenges pre-conceived ideas about middle-age sex.

It not only affirms that it’s OK for older women to be sexually expressive, it annihilates the myth that we become “invisible” and asexual just because we are ageing.

The four-part psychological thriller has prompted a lively debate on this issue and 50-year — old actress Emily Watson, who plays Yvonne, has commented: “Your sexuality doesn’t die with your age. You don’t have to apologise for it.”

The idea that our sexuality can be compartmentalised as non-existent, especially as we are living longer more vital lives, seems absurd.

While Yvonne’s torrid affair illustrates this explicitly, it also raises the issue of how our latent sexual urges are perfectly ripe to be reignited at this stage of life, depending on our circumstances and responses.

“Many women of 50 and beyond succumb to a flagging libido, more difficult arousal and maybe a stale, longtime relationship, by retreating from sex.

“Then they meet someone new and — bam — they feel the excitement that they thought they had left far behind,” says Joan Price, a US author and blogger on senior sexuality.

“They feel on fire. Their sex drive — which they thought was dormant — goes into overdrive. It can be quite an amazing and delicious experience. It can also be bewildering and guilt-filled, if a woman has an affair when she’s in a committed, monogamous relationship.”

Price, now 72, has first- hand experience of this herself: “I was 57 when I met the man who would become my husband and great love. I had been single for decades, with occasional relationships that didn’t go anywhere — and long dry spells.

“It was distressing, because I knew I was a vibrant, sexual being, but after menopause I seemed invisible to the men I met. Many women report that they feel the same. How glorious it is then, when we meet the right person and that person is as electrified as we are!”

The on-screen electricity between research scientist and grandmother-to-be Yvonne, and her handsome lover, Mark Costley (played by Ben Chaplin), is an endorsement of this passionate potential, but is there something missing in our relationship if we yearn to seek those sparks elsewhere?

Sex in relationships is not just about sex, but about the connect between a woman and her partner, says Lisa O’Hara, a couple counsellor with Dublin-based clinic Mind and Body Works.

“If lack of libido is an issue for a couple attending for counselling, it can be part of a wider discontent than just the sexual connection. There may be a loss of closeness in general and resentments by the woman towards the partner that have built up over years, which have gone unaddressed.

“If these are addressed in therapy and things improve, sex may be back once again.”

However, some of her midlife female clients do develop a stronger curiosity about their own desires and fantasies, once free of fear of pregnancy or of other lifestyle issues that had got in the way, says O’Hara.

“Some say ‘I’m out of here’. It totally depends on their unique circumstances and how they feel about themselves.”

The myth that we become less sexual as we age was recently explored in research among women aged 55 to 81, titled Sex, Desire and Pleasure: Considering the experiences of older Australian Women.

Research author Bianca Fileborn, a lecturer in the School of Social Sciences at the University of New South Wales, tells Feelgood: “One of the key findings from our research was that women are really diverse — there’s certainly not one way that older women are ‘doing’ sexuality and sexual desire in mid to later life.

Emily Watson’s as character Yvonne Carmichael in the BBC production of ‘Apple Tree Yard’.

“In fact quantitative research carried out in western countries pretty consistently shows that a significant number of older people remain sexually active — usually a majority — at least until they reach ‘deep’ old age, in their 80s and 90s. But even then, a large minority still have sex.

“Another key finding for us was that women’s desire for sex didn’t depend necessarily on how older they were, but what else was going on their lives that influenced them.”

Irish sexologist Emily Power Smith says she knows women of all ages who, although they’re living with chronic illness and pain, are “determined to find ways to feel sexual”.

“Women who enjoy sex will have sexual desire right to the end of their lives and will find creative ways to keep that spark. But I also work with a number of women in their 50s and above, who want to know what all the fuss is about, because they could quite easily never have sex again.

“Inevitably it transpires that they have never really enjoyed sex. As they begin to discover their ability to feel sexual pleasure and arousal, their drives tend to increase.”

ONCE we are leading healthy lives low libido seems more related to the kind of sex we are having, rather than our age, she says.

“I know many young fertile women who hate sex and many older women, post menopause, who love it. Increasingly, there is research to show that older women embarking on new relationships report no reduction whatsoever in their sexual desire.”

Whatever about the complex rich reality of older women’s everyday sex lives, the screening of Apple Tree Yard may nudge the film and media world towards a more rounded representation of the mature female in all her sensual glory.

And perhaps even encourage women to explore their own sexuality more.

There is a growing posse of sexy women in their 50s and older decades, gracing the fashion and beauty world, in recent times, apart from the fact that some of the original supermodels of the ’90s, such as Cindy Crawford, Elle Macpherson and Linda Evangelista are already past the half century mark.

This year’s Pirelli calendar also sees photographer Peter Lindbergh tap into the zeitgeist, describing the make-up free portraits of his subjects as a “cry against perfection and youth”.

Some of the high-achieving women he chose to feature were actresses Julianne Moore, 56, Charlotte Rampling, 70, and Helen Mirren, 71.

However, despite this celebration of our vitality as we age, we still may have some catching up to do as individuals, says Power Smith.

“Women do a lot of self-policing when it comes to behaviour, dress and dating over a certain age. I think we are so conditioned to believe our lives are over once we’re 50 — though this is changing slowly — we get very troubled at the thought of our peers wearing short skirts, or dating younger people. But the rules don’t serve us. They never did.

“Only now some of us have the financial freedom, confidence and ability to create new norms. So come on! Let’s break some rules!”

Apple Tree Yard, BBC One, Sunday February 5, 9pm

10 ways to feel sexy

Senior sexpert, author and blogger, Joan Price, gives us these 10 tips for hot sex after 50:

1. Slo-o- o-w- w down. It takes longer for us to warm up, and this intensifies as we get older. Make the warm-up phase of sex play last hours… or days.

2. Appreciate, decorate, and celebrate your body. Jewellery, lingerie, feathers, fringe, silk, velvet, massage oil, candlelight — whatever looks good and feels good. If you know you look sexy, you’ll feel sexy.

3. Learn what you like. Explore, experiment. If you’re partnered, communicate what you like.

4. Do sexy things on your own to get in the mood long before you get naked. Work out. Swim. Dance. Fantasise a sexy scene. Spend some time humming with a vibrator, reading erotica, or watching porn — or all of these.

5. Have sex during high energy times, when your arousal is strongest, whether solo or partnered.

6. If you’re partnered, kiss and kiss. Kiss sweetly, passionately, quickly, slowly, contentedly, hungrily, lightly. All kinds of kisses help you bond with your partner, warm up, and enjoy the moment.

7. Explore sex toys and other erotic helpers, alone and/or with a partner. Lucky for us that sex toys are easy to find, fun to try, and wow, do they work!

8. Use a silky lubricant. There are many different lubricants made specifically for sex that feel great and enhance (or bring back) the joy of friction. Make applying lubricant an erotic part of sex play.

9. Enjoy the afterglow. If you’re partnered, indulge in quality snuggle time.

Solo, don’t get back to your daily life right away — bask in your feelings of wellbeing.

10. Laugh a lot. Laughter is joyful, ageless — and sexy.

Complete Article HERE!

Better Sleep Could Mean Better Sex for Older Women

By Robert Preidt

A more satisfying sex life may be only a good night’s sleep away for women over 50, new research finds.

Researchers led by Dr. Juliana Kling of the Mayo Clinic in Scottsdale, Ariz., tracked data from nearly 94,000 women aged 50 to 79.

The investigators found that 31 percent had insomnia, and a little more than half (56 percent) said they were somewhat or very satisfied with their sex life.

But too little sleep — fewer than seven to eight hours a night — was linked with a lower likelihood of sexual satisfaction, the findings showed.

“This is a very important study since it examines a question which has tremendous potential impact on women’s lives,” said Dr. Jill Rabin, who reviewed the findings. She’s co-chief of the Women’s Health Program at Northwell Health in New Hyde Park, N.Y.

Age played a key role in outcomes. For example, the study found that older women were less likely than younger women to be sexually active if they slept fewer than seven to eight hours per night.

Among women older than 70, those who slept fewer than five hours a night were 30 percent less likely to be sexually active than women sleeping seven to eight hours, Kling’s team found.

The findings highlight how crucial sleep is to many aspects of women’s health, medical experts said.

“Seven hours of sleep per night will improve sexual satisfaction and has been shown to increase sexual responsiveness,” said Dr. JoAnn Pinkerton, executive director of The North American Menopause Society.

Besides putting a damper on sex lives, she said, poor sleep is also tied to an array of health issues, such as “sleep apnea, restless legs syndrome, stress and anxiety.” Other health problems linked to insomnia include “heart disease, hypertension [high blood pressure], arthritis, fibromyalgia, diabetes, depression and neurological disorders,” Pinkerton added.

Dr. Steven Feinsilver directs sleep medicine at Lenox Hill Hospital in New York City. He reviewed the new findings and stressed that they can’t prove cause and effect. “It certainly could be possible that many underlying problems — for example, illness, depression — could be causing both worsened sleep and worsened sex,” he noted.

Rabin agreed, but said there’s been “a paucity of studies” looking into links between sleep and sexual health, especially during menopause.

“We know that obstructive sleep apnea and sexual dysfunction are positively correlated,” she said. “Other factors which may lead to a decreased sleep quality include: a woman’s general health; various life events, which may contribute to her stress; chronic disease; medication; and degree and presence of social supports, just to name a few,” Rabin explained.

And, “in menopause, and due to the hormonal transition, women may experience various symptoms which may impact the duration and quality of their sleep patterns,” Rabin added.

We and our patients need to know that quality sleep is necessary for overall optimum functioning and health, including sexual satisfaction, and that there are effective treatment options — including hormone therapy — which are available for symptomatic women,” she said.

The study was published online Feb. 1 in the journal Menopause.

Complete Article HERE!

What getting intimate at 60 really means

Most people assume getting saucy under the sheets it just for the young, but what about the young at heart?

By Ashley Macleod and Marita McCabe

Sexuality encompasses sex, gender identities and roles, sexual orientation, eroticism, pleasure, intimacy and reproduction and what we think, feel and believe about them. It has been a research focus for over a hundred years, and highlighted as an important part of the human experience. Since the first studies on human sexuality in the 1940s, research has consistently demonstrated that sexual interest and activity are sustained well into old age. However, only a fraction of the research has explored sexuality in the later years of life.

Most of the early research on sexuality and ageing looked at the sexual behaviours and biology of older adults, generally ignoring the wider concept of sexuality. When researchers did discuss sexuality more broadly, many referred to sexuality as the domain of the young, and emphasised this was a major barrier to the study of sexuality in older adults.

Sexuality in later life ignored

Towards the end of the 20th century, research expanded to include attitudes towards sexual expression in older adults, and the biological aspects of sexuality and ageing. Consistently, the research showed sexual expression is possible for older adults, and sustained sexual activity into old age is more likely for those who had active sex lives earlier in life.

By the late 1980s, there was a strong focus on the biological aspects of ageing. This expanded to include the reasons behind sexual decline. The research found these were highly varied and many older adults remain sexually active well into later life.

But despite evidence adults continue to desire and pursue sexual expression well into later life, both society in general and many health professionals have inadvertently helped perpetuate the myth of the asexual older person. This can happen through an unintentional lack of recognition, or an avoidance of a topic that makes some people uncomfortable.

Why does this matter?

These ageist attitudes can have an impact on older adults not only in their personal lives, but also in relation to their health needs. Examples include the failure of medical personnel to test for sexually transmissible infections in older populations, or the refusal of patients to take prescribed medications because of adverse impacts on erection rigidity. We need more health practitioners to be conscious of and incorporate later life sexuality into the regular health care of older adults. We still have a long way to go.

By ignoring the importance of sexuality for many older adults, we fail to acknowledge the role that sexuality plays in many people’s relationships, health, well-being and quality of life. Failure to address sexual issues with older patients may lead to or exacerbate marital problems and result in the withdrawal of one or both partners from other forms of intimacy. Failure to discuss sexual health needs with patients can also lead to incorrect medical diagnoses, such as the misdiagnosis of dementia in an older patient with HIV.

It’s not about ‘the deed’ itself

In a recent survey examining sexuality in older people, adults aged between 51 and 89 were asked a series of open-ended questions about sexuality, intimacy and desire, and changes to their experiences in mid-life and later life. This information was then used to create a series of statements that participants were asked to group together in ways they felt made sense, and to rank the importance of each statement.

The most important themes that emerged from the research encompassed things such as partner compatibility, intimacy and pleasure, and factors that influence the experience of desire or the way people express themselves sexually. Although people still considered sexual expression and sexual urges to be important, they were not the focus for many people over 45.

Affectionate and intimate behaviours, trust, respect and compatibility were more important aspects of sexuality than intercourse for most people. Overall, the message was one about the quality of the experience and the desire for connection with a partner, and not about the frequency of sexual activities.

People did discuss barriers to sexual expression and intimacy such as illness, mood or lack of opportunity or a suitable partner, but many felt these were not something they focused on in their own lives. This is in line with the data that shows participants place a greater importance on intimacy and affectionate behaviours such as touching, hugging and kissing, rather than intercourse.

These results help us challenge the existing stereotype of the “asexual older person” and the idea intercourse is necessary to be considered sexually active. They also make it clear researchers and health practitioners need to focus on a greater variety of ways we can improve the experience and expressions of sexuality and intimacy for adults from mid-life onwards beyond medical interventions (like Viagra) that focus on prolonging or enhancing intercourse.

Complete Article HERE!

Middle-aged sex without the mid-life crisis

More people are dating in middle age, but are they looking after their sexual health?

A regular, happy sex life can benefit our physical, mental, emotional and social wellbeing, improving health and prolonging life

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With more middle-aged people dating, or starting new relationships than ever before, are we taking enough care and consideration of our sexual health?

When we think of the faces behind recent statistics that are showing a rise in sexually transmitted diseases (STDs), we probably picture someone young. Those irresponsible students and twentysomethings playing around and not thinking through the consequences of their actions. But not so much. It is becoming clear that a large proportion of people contributing to those statistics are in fact, middle-aged. The Irish Family Planning Association (IFPA) annual report highlighted an increase in women aged over 50 coming to the clinics for sexual health services, including sexually transmitted infection screening and menopause check-ups.

The association said there was a perception that once women reached menopause, that they no long needed sexual health services. But that’s not the case. Minding our sexual health all through our life is as important as looking after our physical and mental health.

Unplanned pregnancies

For many women, perhaps coming out of a long marriage or relationship, they perhaps don’t seem to think they have to go back to the good old days of contraception and protection. Yet there are more unplanned pregnancies in the 40-plus age group than the younger ages.

“We definitely see an innocence and a lack of knowledge in middle-aged women seeking our services,” says Caitriona Henchion, medical director of the IFPA. “We see women not knowing if they need emergency contraception or whether they are experiencing menopausal symptoms. They’re not sure even in their late 40s and early 50s whether they still need contraception.”

The recommendation for contraception is very simple, yet perhaps not widely known. Until you have not experienced periods for two full years and you are under the age of 50, or one full year without periods after the age of 50, you need to still consider contraception. Amid constant talk of falling fertility as we age, many women are confused about their contraception needs.

This lack of knowledge about sexual health needs is apparent not just in the number of unplanned pregnancies in older women, but the rise of STDs in that age group as well. According to Henchion, advice from GPs can sometimes vary in quality and quantity, and so any sexually active woman over the age of 40 needs to seriously consider both her health risks and contraception needs.

Regular screening

The recommendation is that anyone who is sexually active needs regular screening. This seems to be something that many women feel unable to do. But emerging from a marriage or long-term relationship where the partner may have had other sexual partners means that STD screening is imperative.

“Discovering an unfaithful partner is a really common reason that we see older women coming to our clinics for screening,” says Henchion. “Our advice would be that the first thing to consider when starting with new partners is to ensure you have safer sex with condoms.”

But condoms don’t protect against everything, so the recommendation from the IFPA would be that if in sexual relationships you need to have testing twice a year.

“Obviously the people I see are a self-selecting group who are sexually active and attending our services, but certainly I would see a lot more people in the 50-plus [group] who are openly talking about their wants and needs and their problems with it, which is great,” explains Henchion. Who they do not see are the men and women not seeking sexual health services, or asking openly about their needs

One of the reasons there is a rise in general of STDs is because far more tests are being carried out, and therefore, more positive results. The tests are better now for chlamydia and gonorrhoea, so whereas a few years ago tests had less than 75 per cent detection rate, today it is 99 per cent. The tests themselves are simple. For men with no symptoms it is a straightforward urine sample and blood test, and for a woman, a vaginal swab and blood test in a nurse-led clinic.

Simple rule

According to Henchion, “the simple rule would be if you have a new partner for a few weeks, get tested.” But for many people, we perhaps don’t even know what to look for.

The top three STDs in terms of prevalence would be chlamydia, warts and herpes, and although many of the symptoms are obvious such as bleeding or physical warts, in more than 50 per cent of cases there are no symptoms. How many cases are picked up is through automatic testing when going for certain contraception options such as the coil.

Henchion believes we need better sex education and awareness for all generations. “I see 21-year-olds coming in with no understanding of how STDs such as herpes and warts can still be spread even though they are using condoms. And for sexually active people in middle age, there is often a significant lack of knowledge.”

For now, until sexual health education is more widely available, there are plenty of support services including GPs, well woman/well man sexual health clinics and the Guide Clinic at St James’s Hospital. The IFPA offers free advice, and there are plenty of online services such as HealthyIreland.ie.

“The key message is that early detection makes a huge difference in reducing risk of pelvic infection and obviously reducing the risk of passing it on,” warns Henchion. “Anyone, whatever age, who is sexually active needs to mind their sexual health.”

Middle-aged, single and on fire – or talking ourselves celibate?

For many women who have reached the supposed sexual prime of their 40s and 50s, their body image is shattered along with their energy. A recent survey suggested some women in this age bracket have the lowest confidence of any other age group regarding body image, and it’s affecting their sex lives. Yet another survey highlighted the fact that some women in middle age are having the best sex of their lives. If both surveys are right, is it all just down to attitude, and can changing your attitude change your sexual mojo?

In the two decades since the iconic shenanigans of the “man-eater” Samantha shocked a nation in Sex and the City (while women everywhere sniggered at the delight of it), middle-age sex is becoming mainstream. The BBC were at it with Happy Valley, and even Cold Feet caught up. First time round, Adam and co were in their youth, but now that they are heading towards 50, who is the one having all the sex? Karen. Middle-aged, single and on fire. Now that ordinary middle-aged women are being shown to be – gasp! – sexual, it begs the question: what does this mean for us? Is this liberating or intimidating?

It seems your answer to that question is the difference between having an active sex life in and beyond middle age and putting away the sexy knickers and taking out the comfy slippers.

Like tight skin and fashionable clothes, sex used to be the domain of the young. But now middle-aged women can have tight skin, fashionable clothes and sex as well. It all depends on your attitude. If you think your sex life is over at 50, it will be.

“Attitude is so important,” says sex therapist Kate McCabe. “I see women challenging traditional values and beliefs that you are past it sexually after a certain age. Women are having babies later, new relationships later, are mentally and physically healthier and anxious to be active and participate fully in every aspect of their lives.”

In fact, a regular, happy sex life can benefit our physical, mental, emotional and social wellbeing, improving health and prolonging life. This generation of middle-aged women have opportunities to redefine what stereotype they fit into, experiencing greater sexual, financial, social and intellectual freedom than at any previous time. Contraception has meant we are not overburdened with childbearing, and openness about sex means that issues which might have caused discomfort and difficulty can be addressed. The increase in divorce and separation now means that middle-aged dating is an acceptable social norm.

So why are all middle-aged women not taking advantage of the chance to flirt their 50s away and sex up their 60s

“Sex must be worth it,” explains McCabe. “I see women who come into therapy to see how they can best improve their sex life, even to the extent that they’ll bring in their partners and manage to engage in that conversation.

And it’s women of all ages. McCabe has clients in their 60s and 70s. “They are definitely getting out there, and they want really good, honest information on how to make the most of their sexual potential.”

But what about those women who are talking themselves celibate because of lack of confidence? Media plays a huge part in how women can often rate themselves. According to McCabe, feeling sensual has nothing to do with how you look.

“Finding intimacy is a brave step. Overcoming hang-ups to really explore our own sensuality is vital. And much of it relies on getting the right attitude.”

Complete Article HERE!